Provider Demographics
NPI:1154311124
Name:GRIEP, STEPHEN GERALD (PA)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:GERALD
Last Name:GRIEP
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:UNIT 3865
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09126
Mailing Address - Country:DE
Mailing Address - Phone:004-965-6169
Mailing Address - Fax:3457
Practice Address - Street 1:UNIT 3865
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09126
Practice Address - Country:DE
Practice Address - Phone:004-965-6169
Practice Address - Fax:3457
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NA363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical